27026_WIARD, DARRELL_20001123

CAMA and DREDGE AND FILL 27026 _
2
G E N E R A L L_ i
PE R M I T >��►��`�,�
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Applicant Name Phone Number
Address
City State zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
(SCALE:
Pier (dock) Length
M
,
'
` 1
-i
f '
°�
Groin Length
,...........
;,
number
I
t.
44
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
i
i
it
__.
Other
fi«
This permit is subject to compliance with this application, site drawing
and attached general and specific conditions. Any violation of these terms
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project is consistent with the local
land use plan and all local ordinances, and 2) a written statement has
been obtained from adjacent riparian landowners certifying that they
have no objections to the proposed work.
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program.
issuing date
applicant's signature
permit officer's signature
expiration date
attachments
application fee

UNITED STATES• .. . � � is • eoo
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86191,679024 001128 28 150 *100*00
SERIAL NIIMRFR
PAY TO - _ _—
CHECKWRITER
IMPRINT AREA
- ADDRESS
FROM
NO
U EDFOR ORY
J?rrr�l 1 it/ritra� �P' �70a1p NEGOTIABLE ONLY IN._THC,U.S. AND Pot SSES5(Ot•!S
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I hereby =dfy tWt I v M Pip ty' Adj t
(Name of jim, rtv
proPeny Imaledd at_
an
(WatF-�djc
In
(Town an&or Y)
He has deu-64 -i )aa 3-r�t9 as shown below, the dtvei0Pn1U-nt ;-e 3.s Tsang at that
towtion, &" d, I have ;'O c"Woris to his proposal. I unde sd ;rat a Piacluaw ►erect be -at Taft
must d by mset e, �� °iaa,,ttn �ia.;�
exi
waivWee of" fifte= feet (IS=) from my aIM :•,A ..;Pariarl amass )anieSs
i dQ . ,h t+j Vvaive the setback requirement.
Ic -* :Ive that setback requirement.
ANWOR MA' ING OF MOPOSIM 4' + .� a� l� r:
.�o he,mod in by in&viduW proposing dsyf ,p. , .:sE,)
Print or Type Name
e-I hi t N u m hex
Batt:

r
I hsreby certify tt kt I c-.m proper ty adjacent
(Name of n o;.«"y O ms.r)
property located at
on Y
Yr (Town an&or )
Y
He has doss r- -A W ;?ae, as shown below, the developjrA;;.,t 'Pe ,.s 7,nvgxsing at that
location, a,s;d, T have- - r =' ians to his proposal. t understmd uyat $ Pi 'uucoventd bt,at lift
must be set bark a ��a}: ,��n d4=ce of fifteen feet (15s) from my az� . ,1-ip,�aJ� ==s tuilms
waived by me.
r dQ 4vl to v4i;eve the sed ack reQuireamt.
is 4 AIve chat setback rNuimment.
DFSCY 5 0 z .-; AN910R 1-WRA'WING OF PROPOSES a.;� T: -
e a At ,0flrd in by individual proposing 4W16P ss 5
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Rgr'ature
Print or Type Name
3
rlcphone Number
Date: I ( 0 d